Neurosurgery and Neuroscience

Tip-toe walking is a well-known problem in children which leads their parents to consult a specialist. This condition usually is difficult to differentiate between neurological and orthopedic disorder that’s why it needs a multidisciplinary approach and cooperation of different specialists to find a diagnosis and determine the correct treatment. 25 children with tip-toe walking (aged 1-15 years) were examined by neurologist and orthopedist. To find out the main reason of walking disorder a number of neurophysiological and radiodiagnostic methods were used. The neurophysiological investigations included EMG of lower limb muscles, NCS, TMS. Imaging included US and MRI of lower limbs muscles. Radiological method was chosen according to the age of a child. Based on the results of all examinations and investigations children were put to a diff erent group: CNS disorder, neuromuscular disorder, orthopedic disorder - and they got treatment accordingly. These results show the importance of considering not only clinical examination by specialists, but also different types of investigations (neurophysiological and imaging) for optimizing the approach to full diagnostic and proper treatment and rehabilitation approach to children with idiopathic tip-toe walking.